Congenital idiopathic chylothorax is the accumulation of chylous fluid in the pleural space. Typically occurs in the late third trimester and possible explanations are malformation and leakage from the thoracic duct. We report an index case in a Jamaican neonate diagnosed with polyhydramnios and bilateral pleural effusions by routine sonography at 34 weeks gestational age. Antenatal diagnostic work up done aimed to exclude hydrops fetalis and its numerous aetiologies. We highlight our limitations.At birth elective mechanical ventilation was essential and bilateral thoracostomy tubes placed were both diagnostic and therapeutic. The infant received a specialized diet exclusively for 8 weeks and regular feeds were tolerated at 8 weeks. The rarity of this condition, diagnostic limitations such as ready availability of karyotyping, limited facilities for antenatal intervention may present surmountable management challenges.
{"title":"Congenital Idiopathic Chylothorax In A Jamaican Neonate: Management Challenges","authors":"O. Aworanti","doi":"10.5580/1bd1","DOIUrl":"https://doi.org/10.5580/1bd1","url":null,"abstract":"Congenital idiopathic chylothorax is the accumulation of chylous fluid in the pleural space. Typically occurs in the late third trimester and possible explanations are malformation and leakage from the thoracic duct. We report an index case in a Jamaican neonate diagnosed with polyhydramnios and bilateral pleural effusions by routine sonography at 34 weeks gestational age. Antenatal diagnostic work up done aimed to exclude hydrops fetalis and its numerous aetiologies. We highlight our limitations.At birth elective mechanical ventilation was essential and bilateral thoracostomy tubes placed were both diagnostic and therapeutic. The infant received a specialized diet exclusively for 8 weeks and regular feeds were tolerated at 8 weeks. The rarity of this condition, diagnostic limitations such as ready availability of karyotyping, limited facilities for antenatal intervention may present surmountable management challenges.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With improved survival of extremely premature neonates, use of peripherally inserted central catheter (PICC) lines has gained favor as a means for providing parenteral nutrition. Improvements in technology have made their use safe. Pericardial effusion (PE) and cardiac tamponade resulting from placement of a PICC line is a rare but serious complication. There is controversy about the ideal location of the tip of the PICC line. We present a case of cardiac tamponade secondary to a PE following PICC line placement. We also have reviewed the literature for this complication.
{"title":"Cardiac tamponade following central line in premature neonate: Case report and review of the literature","authors":"R. Shenoy","doi":"10.5580/1c0d","DOIUrl":"https://doi.org/10.5580/1c0d","url":null,"abstract":"With improved survival of extremely premature neonates, use of peripherally inserted central catheter (PICC) lines has gained favor as a means for providing parenteral nutrition. Improvements in technology have made their use safe. Pericardial effusion (PE) and cardiac tamponade resulting from placement of a PICC line is a rare but serious complication. There is controversy about the ideal location of the tip of the PICC line. We present a case of cardiac tamponade secondary to a PE following PICC line placement. We also have reviewed the literature for this complication.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70815623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pulmonary Interstitial Emphysema (PIE) is a well documented complication of mechanical ventilation, but it also seen in unventilated premature babies. When an apparently healthy, near-term 2 week old infant suddenly developed respiratory distress, PIE was excluded clinically, despite the characteristic honeycomb appearance of the lungs on chest X-ray. However, rare cases of term unventilated babies with PIE are reported in the literature and this was later found to be the underlying diagnosis. This case is reported to highlight the challenges and complexities of routine medical practice, as well as the need for clinicians to keep in mind rarer differential diagnoses like PIE in a healthy term baby.
{"title":"Spontaneous Diffuse Pulmonary Interstitial Emphysema (PIE) in an unventilated infant","authors":"S. Bhojani, D. Bird, G. Alok","doi":"10.5580/2774","DOIUrl":"https://doi.org/10.5580/2774","url":null,"abstract":"Pulmonary Interstitial Emphysema (PIE) is a well documented complication of mechanical ventilation, but it also seen in unventilated premature babies. When an apparently healthy, near-term 2 week old infant suddenly developed respiratory distress, PIE was excluded clinically, despite the characteristic honeycomb appearance of the lungs on chest X-ray. However, rare cases of term unventilated babies with PIE are reported in the literature and this was later found to be the underlying diagnosis. This case is reported to highlight the challenges and complexities of routine medical practice, as well as the need for clinicians to keep in mind rarer differential diagnoses like PIE in a healthy term baby.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70820669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cerebral hemiatrophy is not frequently encountered in clinical practice in children. We present here a case of 4 years old female child, who presented with seizures and weakness of left upper and lower limb and on MRI diagnosed to have Dyke Davidoff Masson Syndrome (DDMS).
{"title":"Dyke Davidoff Masson syndrome in Children","authors":"J. Goyal, V. B. Shah, S. Rao, N. Jindal","doi":"10.5580/10ad","DOIUrl":"https://doi.org/10.5580/10ad","url":null,"abstract":"Cerebral hemiatrophy is not frequently encountered in clinical practice in children. We present here a case of 4 years old female child, who presented with seizures and weakness of left upper and lower limb and on MRI diagnosed to have Dyke Davidoff Masson Syndrome (DDMS).","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70811381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The case of a young girl who developed acute pancreatitis in the course of acute hepatitis A is reported along with relevant literature review. The rarity of this complication in children (compared to young adults) even in endemic areas where water borne viral hepatitis affects large number of children is highlighted.
{"title":"Severe acute pancreatitis complicating acute hepatitis A in a child","authors":"G. Ray, D. Bandopadhyay","doi":"10.5580/2386","DOIUrl":"https://doi.org/10.5580/2386","url":null,"abstract":"The case of a young girl who developed acute pancreatitis in the course of acute hepatitis A is reported along with relevant literature review. The rarity of this complication in children (compared to young adults) even in endemic areas where water borne viral hepatitis affects large number of children is highlighted.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70818971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Pavone, A. Pira, M. Caruso, P. Pavone, O. Palumbo, M. Carella, T. Mattina
We report the case of a three years old male child who showed ambiguous genitalia in a setting of multiple malformations. Disorders of sex development (DSD) are due to many different causes, such as chromosome abnormalities, or alterations in transcription factors, receptors, and hormones implicated in sexual differentiation during fetal life. Here we describe a case of partial deletion 7q ter associated with partial trisomy 16p as a new chromosome anomaly associated with ambiguous genitalia. We have attempted to analyse the individual contributions of chromosomes 7 and 16 in the pathogenesis of the sex malformation in our patient.
{"title":"A NEW CAUSE OF AMBIGUOUS GENITALIA: MULTIPLE MALFORMATIONSYNDROME RELATED TO AN UNBALANCED TRANSLOCATION [46,XY t(7;16)]","authors":"L. Pavone, A. Pira, M. Caruso, P. Pavone, O. Palumbo, M. Carella, T. Mattina","doi":"10.5580/c5f","DOIUrl":"https://doi.org/10.5580/c5f","url":null,"abstract":"We report the case of a three years old male child who showed ambiguous genitalia in a setting of multiple malformations. Disorders of sex development (DSD) are due to many different causes, such as chromosome abnormalities, or alterations in transcription factors, receptors, and hormones implicated in sexual differentiation during fetal life. Here we describe a case of partial deletion 7q ter associated with partial trisomy 16p as a new chromosome anomaly associated with ambiguous genitalia. We have attempted to analyse the individual contributions of chromosomes 7 and 16 in the pathogenesis of the sex malformation in our patient.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70827147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Neonatal encephalopathy is important for its association with significant morbidity and mortality in the newborn period as well as chronic handicapping conditions later in life. It most commonly occurs following perinatal asphyxia and causes significant brain damage. Although, it is characterized by specific clinical and neuroimaging features, the management of the condition is largely supportive. Recent advances in the pathophysiology of neonatal encephalopathy include the role of increased cytosolic influx of calcium ions, excitatory amino acid neurotransmitters and mediators of inflammation like nitric oxide and free radicals in the disruption of neuronal metabolism thus, resulting in widespread neuronal deaths. The role and clinical applicability of these pathophysiological proposals in selecting management options for neonatal encephalopathy are discussed.
{"title":"Management Options In Neonatal Encephalopathy","authors":"M. Ogundeyi, T. Ogunlesi","doi":"10.5580/294e","DOIUrl":"https://doi.org/10.5580/294e","url":null,"abstract":"Neonatal encephalopathy is important for its association with significant morbidity and mortality in the newborn period as well as chronic handicapping conditions later in life. It most commonly occurs following perinatal asphyxia and causes significant brain damage. Although, it is characterized by specific clinical and neuroimaging features, the management of the condition is largely supportive. Recent advances in the pathophysiology of neonatal encephalopathy include the role of increased cytosolic influx of calcium ions, excitatory amino acid neurotransmitters and mediators of inflammation like nitric oxide and free radicals in the disruption of neuronal metabolism thus, resulting in widespread neuronal deaths. The role and clinical applicability of these pathophysiological proposals in selecting management options for neonatal encephalopathy are discussed.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70820938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rubinstein Taybi syndrome is a rare malformative syndrome characterised by dysmorphic features and mental retardation. In the neonatal period the diagnosis can be facilitated by the presence of broad thumbs and great toes. Psychomotor and social retardation is present in most of the patients.Most cases are sporadic. The present case has all the main characteristics of RubinTaybi syndrome associated with dandy walker variant diagnosed on antenatal MRI as well as post natal Ct scan. CASE REPORT A female first born infant was delivered at term by caesarean section. She was found to have a Dandy walker variant on the antenatal scans and later was confirmed by the foetal MRI. Figure 1 Cystic dilatation with agenesis of Cerebellar vermis. Post natal Ct confirmed the same. Figure 2 Cerebellar vermis agenesis with cystic dilatation Mother declined all genetic screening. A term neonate born to a primigravida by caesarean section was found to have clinical features consistent with Rubinstein Taybi syndrome. She weighed 2.8 kg had a head circumference of 32 cms .She was found to have hypertrichosis, low hair line, marked hypertelorism, short filtrum ,puffy eye lids and broad toes and thumbs. Dandy walker variant an association with Rubinstein Taybi syndrome
{"title":"Dandy walker variant an association with Rubinstein Taybi syndrome","authors":"N. Pandya, G. Rebello, C. Deshpande","doi":"10.5580/1977","DOIUrl":"https://doi.org/10.5580/1977","url":null,"abstract":"Rubinstein Taybi syndrome is a rare malformative syndrome characterised by dysmorphic features and mental retardation. In the neonatal period the diagnosis can be facilitated by the presence of broad thumbs and great toes. Psychomotor and social retardation is present in most of the patients.Most cases are sporadic. The present case has all the main characteristics of RubinTaybi syndrome associated with dandy walker variant diagnosed on antenatal MRI as well as post natal Ct scan. CASE REPORT A female first born infant was delivered at term by caesarean section. She was found to have a Dandy walker variant on the antenatal scans and later was confirmed by the foetal MRI. Figure 1 Cystic dilatation with agenesis of Cerebellar vermis. Post natal Ct confirmed the same. Figure 2 Cerebellar vermis agenesis with cystic dilatation Mother declined all genetic screening. A term neonate born to a primigravida by caesarean section was found to have clinical features consistent with Rubinstein Taybi syndrome. She weighed 2.8 kg had a head circumference of 32 cms .She was found to have hypertrichosis, low hair line, marked hypertelorism, short filtrum ,puffy eye lids and broad toes and thumbs. Dandy walker variant an association with Rubinstein Taybi syndrome","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70814610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Citrobacter koseri meningitis is a very rare cause of neonatal meningitis. It is characterized by serious complications like cerebral abscesses and high mortality. This is the first neonatal case of cerebral abscesses in UK following C. koseri meningitis, who survived with no serious neurological deficit. Serial neuroimaging is the key to diagnose cerebral complications early. Neonatal meningitis is a well known serious clinical condition associated with significant morbidity and mortality12 which can be complicated by brain abscess formation and ventriculitis.3456 Although there has been a decrease in the overall mortality in the last decade attributable to improved supportive care and the use of more efficacious antibiotics such as third generation cephalosprorins,7 the incidence and morbidity attributed to this condition has remained largely unchanged.12 Up to forty-five percent of neonatal meningitis is caused by Gram negative bacilli, 123 and is associated with high morbidity7 and mortality of about eighty percent.4 Neonatal meningitis caused by Citrobacter koseri is extremely rare and is often complicated by brain abscess and ventriculitis, with only a few cases reported from the USA,345 India,8 Brazil,9 Israel,10 and Canada.11 In the UK, there have been ten reported cases of Citrobacter meningitis, 12131415 nine of which were C. koseri and one C. freundii.
{"title":"Neonatal Citrobacter koseri meningitis and brain abscess","authors":"U. Kariholu, J. Rawal, S. Namnyak","doi":"10.5580/1eaa","DOIUrl":"https://doi.org/10.5580/1eaa","url":null,"abstract":"Citrobacter koseri meningitis is a very rare cause of neonatal meningitis. It is characterized by serious complications like cerebral abscesses and high mortality. This is the first neonatal case of cerebral abscesses in UK following C. koseri meningitis, who survived with no serious neurological deficit. Serial neuroimaging is the key to diagnose cerebral complications early. Neonatal meningitis is a well known serious clinical condition associated with significant morbidity and mortality12 which can be complicated by brain abscess formation and ventriculitis.3456 Although there has been a decrease in the overall mortality in the last decade attributable to improved supportive care and the use of more efficacious antibiotics such as third generation cephalosprorins,7 the incidence and morbidity attributed to this condition has remained largely unchanged.12 Up to forty-five percent of neonatal meningitis is caused by Gram negative bacilli, 123 and is associated with high morbidity7 and mortality of about eighty percent.4 Neonatal meningitis caused by Citrobacter koseri is extremely rare and is often complicated by brain abscess and ventriculitis, with only a few cases reported from the USA,345 India,8 Brazil,9 Israel,10 and Canada.11 In the UK, there have been ten reported cases of Citrobacter meningitis, 12131415 nine of which were C. koseri and one C. freundii.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70816669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Osteopetrosis is an extremely rare inhereditory bone disorder, in which defective bone resorption by osteoclasts leads to excessive bone deposition. Though, there is usually calcium excess in osteopetrosis, rickets has been described rarely as a paradoxical complication of infantile osteopetrosis and it results from the inability of the osteoclasts to maintain a normal calcium-phosphorus balance in the extracellular fluid. It is rare paradoxical association. We report two cases of infantile osteopetrosis complicated by rickets and subsequent management issues.
{"title":"Osteopetrorickets- Osteopetrosis with rickets, a rare paradoxical association","authors":"K. Umesh, J. Rajesh","doi":"10.5580/45e","DOIUrl":"https://doi.org/10.5580/45e","url":null,"abstract":"Osteopetrosis is an extremely rare inhereditory bone disorder, in which defective bone resorption by osteoclasts leads to excessive bone deposition. Though, there is usually calcium excess in osteopetrosis, rickets has been described rarely as a paradoxical complication of infantile osteopetrosis and it results from the inability of the osteoclasts to maintain a normal calcium-phosphorus balance in the extracellular fluid. It is rare paradoxical association. We report two cases of infantile osteopetrosis complicated by rickets and subsequent management issues.","PeriodicalId":75037,"journal":{"name":"The Internet journal of pediatrics and neonatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70823611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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